"Anti-Nephrin antibodies" testing is a new biomarker for the following 3 conditions:
- Idiopathic Nephrotic Syndrome
- Minimal Change Disease, and
- Focal Segmental Glomerulosclerosis (FSGS)
These 3 conditions can also be classified as "antinephrin-associated podocytopathies"
What are Anti-Nephrin Antibodies?
A recent study has revealed that individuals with difficult-to-diagnose kidney diseases linked to nephrotic syndrome exhibit uniquely high levels of antinephrin autoantibodies. This discovery suggests a novel biomarker for diagnosing and managing these conditions.
Dr. Nicola Martin Tomas from the University Medical Center Hamburg-Eppendorf highlighted that this finding redefines our understanding of:
- idiopathic nephrotic syndrome,
- minimal change disease (MCD), and
- primary focal segmental glomerulosclerosis (FSGS),
categorizing them as antinephrin-associated podocytopathies. This breakthrough allows patients to understand their condition beyond the previously 'idiopathic' classification.
Presented at the 61st European Renal Association Congress and published in the New England Journal of Medicine, the study addresses the challenge of diagnosing nephrotic syndrome, which is marked by proteinuria leading to complications like infections and blood clots.
Diagnoses usually require kidney biopsies, a procedure less frequently performed, particularly in younger patients, highlighting the need for a reliable biomarker.
In this multicenter study, 357 patients with MCD, FSGS, and other glomerular diseases, along with 182 children with idiopathic nephrotic syndrome, were analyzed.
The control group included 117 participants. Results showed that 44% of adults with MCD and 9% with FSGS had antinephrin autoantibodies, while 52% of children with idiopathic nephrotic syndrome tested positive.
In patients without prior immunosuppression, the prevalence was even higher, with 69% in MCD and 90% in idiopathic nephrotic syndrome.
Importantly, antinephrin autoantibodies were seldom detected in other glomerular diseases, emphasizing their specificity. Additionally, levels of these autoantibodies correlated with disease activity, further supporting their role as a biomarker for monitoring disease progression.
Experimental studies on mice showed that single nephrin immunization could rapidly resolve the disease, even at low antibody concentrations, indicating potential therapeutic implications.
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